HIV Clinical Trial
Official title:
A Cross-sectional Controlled Study to Evaluate the Impact of Hyperbilirubinemia on Markers of Cardiovascular Disease, Neurocognitive Function and Renal Markers in HIV-1 Infected Subjects on Protease Inhibitors
Use of some protease inhibitors is associated with elevations of a blood pigment called
bilirubin. This may occasionally lead to yellowing of the eyes (scleral icterus) or
jaundice, but in the general population bilirubin elevations have been shown to have
antioxidant and anti-inflammatory properties that could be associated with reduced risk of
cardiovascular or other disease events.
Inflammation may also be relevant to neurocognitive impairment in HIV (Human
Immunodeficiency Virus) infection hence elevations of bilirubin may also be protective
against neurocognitive impairment.
The purpose of this study is to evaluate the impact of hyperbilirubinemia (HBR) on risk of
heart and renal diseases, and cognitive function.
Use of some protease inhibitors is associated with unconjugated hyperbilirubinemia as a
result of inhibition of the UGT1A1 enzyme.
Elevated levels of unconjugated bilirubin are best characterized among individuals with
Gilbert syndrome, which is the most common inherited cause of unconjugated
hyperbilirubinemia, present in 3-10% of the general population. Gilbert syndrome arises
through variants in the UGT1A1 enzyme, thus these PIs induce a biochemical picture similar
to Gilbert syndrome. Although elevations of bilirubin may occasionally lead to scleral
icterus or jaundice, cohort studies of individuals with Gilbert syndrome indicate bilirubin
elevations may have antioxidant and anti-inflammatory properties and are associated with
reduced risk of cardiovascular events.
Inflammation may also be relevant to cardiovascular (CV) risk, neurocognitive impairment and
renal disease in HIV infection. This study seeks to investigate any association between
antiretroviral associated HBR and CV risk markers, neurocognitive impairment and renal
dysfunction
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Observational Model: Case Control, Time Perspective: Cross-Sectional
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